AMANDA J GRACE (NPI# 1770767683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770767683 |
| Entity Type | Individual |
| Full Name | AMANDA J GRACE |
| Credential | PA-C |
| Practice Address |
4884 Miller Trunk Hwy Hermantown MN 55811-1504 |
| Practice Telephone | 2182495700 |
| Practice Fax Number | 2182494666 |
| Mailing Telephone | 2182495700 |
| Mailing Fax Number | 2182494666 |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2007-12-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1088 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MN LICENSE | 1088 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972797546 | Amanda L. Grace | Counselor | 224 E. Willamette Ave., Colorado Springs, CO 80903 | 2007-08-28 |
| 1033326582 | Amanda Grace | Counselor | 340 Tesconi Cir Ste C, Santa Rosa, CA 95401-4676 | 2007-05-16 |
| 1497075717 | Amanda Blair Grace | Speech-Language Pathologist | 18268 Petroleum Dr, Baton Rouge, LA 70809-6126 | 2010-06-09 |
| 1134353576 | Amanda Elizabeth Grace | Dentist | 1080 Ben Ali Drive, Suite A, Danville, KY 40422-2547 | 2009-05-13 |
| 1427206663 | Amanda Clare Grace | Counselor | 1385 Mission St, Suite 240, San Francisco, CA 94103-2623 | 2008-08-29 |
| 1396773628 | Amanda Simmons Grace | Emergency Medicine | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2006-06-28 |
| Street Address |
4884 MILLER TRUNK HWY |
| City | HERMANTOWN |
| State | MN |
| Zip Code | 55811-1504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740230929 | Jocelyn A. Dorscher | Family Medicine | 4884 Miller Trunk Hwy, Hermantown, MN 55811-1504 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417515339 | Kyle Olson-merrick | Dentist | 320 W Myrtle St, Ste 100, Duluth, MN 55811 | 2019-06-05 |
| 1184288979 | Pdg, P.a. | Clinic/Center | 4891 Miller Truck Hwy., Suite 100, Hermantown, MN 55811 | 2019-04-26 |
| 1528589843 | Breanna Joy Greenly | Counselor | 4720 Burning Tree Road, Birch Tree Center, Duluth, MN 55811 | 2017-06-28 |
| 1396102398 | Debbie Christian | Registered Nurse | 4815 Burning Tree Rd Suite 100, Duluth, MN 55811 | 2016-01-21 |
| 1831556935 | Megan Marie Paris | Psychologist | 715 East Central Entrance, Duluth, MN 55811 | 2016-01-20 |
| 1740666908 | Angela Fedo | Physical Therapy Assistant | 2101 Trinity Rd, Duluth, MN 55811 | 2015-08-10 |
| 1649657479 | Kayla Stephenson | Specialist/Technologist | 5024 Morris Thomas Road, Hermantown, MN 55811 | 2015-04-30 |
| 1073918843 | Northern Lives Inc. | Assisted Living Facility | 4014 Trinity Road, Duluth, MN 55811 | 2014-10-23 |
| 1114326238 | Donald Hermanson | Specialist/Technologist | 801 Boulder Drive, Apt. 202, Duluth, MN 55811 | 2014-08-14 |
| 1679990857 | Jodie Little | Pharmacist | 801 W. Central Entrance, Shopko Pharmacy 2114, Duluth, MN 55811 | 2014-03-25 |
| Find all providers in zip 55811 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811870 | Leiah Hoffman | Physician Assistant | 4243 Timberridge Ln Apt A, Hermantown, MN 55811-4047 | 2020-11-06 |
| 1033763040 | Alexander Gustav Wray | Physician Assistant | 4855 W Arrowhead Rd, Hermantown, MN 55811-3936 | 2019-07-29 |
| 1871077719 | Emily Patricia Ann Schueller | Physician Assistant | 4855 W Arrowhead Rd, Hermantown, MN 55811 | 2018-09-17 |
| 1235676305 | Thomas James Hirsch | Physician Assistant | 4855 W Arrowhead Rd, Essentia Health Hermantown Clinic, Hermantown, MN 55811-3936 | 2017-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265284 | Foua Vang | Physician Assistant | 689 County Road D E Apt 302, Saint Paul, MN 55117-1263 | 2020-11-08 |
| 1760083059 | Amanda Hanover | Physician Assistant | 10346 Mississippi Blvd Nw, Coon Rapids, MN 55433-4521 | 2020-11-04 |
| 1780284844 | Lily Ganz | Physician Assistant | 2737 Huntington Ave, St Louis Park, MN 55416-3917 | 2020-10-28 |
| 1972103000 | Jaclyn Ann Bautch | Physician Assistant | 24721 State Highway 15, Saint Augusta, MN 56301-9211 | 2020-10-28 |
| 1801496047 | Tanner Vaughn Kramp | Physician Assistant | 3450 Wild Turkey Rd, Red Wing, MN 55066-1762 | 2020-10-27 |
| 1497354955 | Sarah Marti | Physician Assistant | 810 Thornton St Se Apt 904, Minneapolis, MN 55414-3652 | 2020-10-25 |
| 1598364473 | Kylee N Persing | Physician Assistant | 10 4th Ave S, Saint Cloud, MN 56301-3614 | 2020-10-21 |
| 1073112009 | Reece Edward Mcevoy | Physician Assistant | 2638 Sand Trap Rd Se, Rochester, MN 55904-3904 | 2020-10-21 |
| 1679189021 | Anne Elizabeth Drabot | Physician Assistant | 4741 Vincent Ave S, Minneapolis, MN 55410-1843 | 2020-09-21 |
| 1295341055 | Alexandra M Fischer | Physician Assistant | 6256 Juneau Ln N, Maple Grove, MN 55311-4137 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
| City | HERMANTOWN |
| Zip Code | 55811 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.